I have a simple question – does massage really help? I read lot of contrasting information and am keen to hear your opinion. Does it flush out lactic acid? Does it make you less sore? Can it help prevent injury? I get very sore after running and will pay for massage if it helps. Thank you.

Amit P

I am afraid the answer is not that simple, as most of the evidence for the proposed benefits of massage is indirect and/or weak. That’s not to say it’s worthless, but it can be useful to check exactly what you are hoping to get from the massage and in doing so potentially clear up a few misconceptions and myths.

Let’s start with what massage has been shown to potentially do: relax you. This may sound like a minor benefit and one not worth paying for, but in realising that a lot of the pain we experience can be down to an over-sensitised nervous system, there is a great deal to gain from something that can relax us. We are not just talking about proven reduction in anxiety and depression; we are also referring to increasing recovery and avoiding system overload.

Stress on body and mind

Studies show that in 60-70% of running related injuries, inappropriate training volume is a key factor. Many runners see how too much running can lead to too much physical stress on muscles and tendons, but we often fail to take into consideration how mental stress also adds to overall volume.

Your body has a finite level of reserves before it starts hurting, and massage may be a good way of helping replenish these reserves, along with sleep, nutrition and adequate rest between runs. If relaxation is one of the most well proven benefits of massage, it makes sense to question massage technique that causes excessive pain.

Massage that is too “deep” may cause the system to become even more threatened and sensitised, and increase pain rather than decrease it. My rule for runners is avoid treatment that causes a pain of over 6/10 (where 10 is the most pain you have ever felt). Some runners put up with pain because they believe massage “releases” muscles. If you are talking about general massage relaxing the nervous system so that its hold on muscle tension decreases, then fair enough.

However, if the proposition is that certain techniques “release” tissue and “realign” you in a way that will eliminate pain, this is unlikely.

Reducing soreness

You mention “flushing out lactic acid”. Unfortunately, this is another myth when it comes to the benefits of massage. Studies show that massage actually reduces lactic acid removal from muscle. But the idea that getting rid of lactic acid will reduce soreness is a myth; despite traditional thought, lactic acid is not the cause of muscle pain or soreness after exercise. If you do have a post exercise massage, make sure it is not “deep tissue”.

Gentle massage may help reduce delayed onset of muscle soreness but vigorous massage could make it a worse. Massage can help the nervous system relax, and a relaxed nervous system is a less threatened one, meaning it is likely to output less pain and free up movement. But it’s unlikely to break down adhesions, improve circulation, flush out lactic acid or directly affect healing.

Matt Phillips is a Running Performance Coach & injury specialist at strideuK & studio57clinic. Follow Matt on twitter: @sportinjurymatt